I’ve been thinking and thinking about a patient of mine since yesterday. His name is Giovanni.
Psychiatrists, you might not know, are quite often asked the same unanswerable question: "Why does one become insane?”
When I was younger, I searched and searched for an answer, losing myself in scientific explanations about synapses, neurons and neurotransmitters.
By the end of my studies, I’d realized that the only thing that was clear was that I’d been clutching at straws to justify my work and give it a semblance of scientific dignity. In the years since, I’ve forced myself, in defiance of the authority of my position, to reply with a laconic but honest: "Sorry, but I don't know."
Nourishment and oxygen
So when Giovanni asked me that same question, he was not happy at all with my answer. “Dottoré, how’s it possible that you don't understand why I became crazy?”
When he tried to ask me again one day, I tried a different response:
"Giová, do you cry?"
"Imagine that the tears that you don't shed, that you force yourself not to shed, because that's what you've been taught to do, all end up inside your heart. The heart is an organ that pumps blood, which brings nourishment and oxygen to the whole body. But over time those diverted tears accumulate to the point that the heart begins to pump them instead of your blood. Slowly your body becomes sick, but the part that suffers the most is your brain. Because tears don't contain oxygen and nourishment, just sadness."
I expected a reaction to this fanciful explanation, but instead Giovanni kept quiet and eventually left.
The same truth
The next time I saw him, he said: "Dottoré, I've thought about it. I know you told me about the tears to make me feel better, but maybe you’re right. Because sometimes I feel that I have a lake, more than a heart. But it takes a very powerful pump to pump out all that water, and my heart alone cannot do it. And now that you've explained to me how I became crazy, can you also tell me if I'll ever get better?"
"Do you want another story or do you want the truth?”
"This time, I’d rather have the truth!”
"The answer is always the same then. I'm sorry, Giová, but I don't know this either. But I can tell you one thing for sure. I'll help you slowly, slowly with just a bucket. Because the truth is, not even I have that pump."
Learn more about Worldcrunch's exclusive Dottoré! series here.